IPAC RRRari—a County Department of Public ..ealth 28289
y Improvement Permit
mt A build' g ermit cannot be issued with only an Improvement Permit
onnos:oTv i nrennru. 17— 1 T f_ r,. Q rel
ISSUED TT0/: � z,�/ - % C
�', i od( SUBDIVISION LOT #
NEW L� REPAIR ❑ EXPANSION ❑ Site Improvements required prior to Construction Authorization Issuance:
Type of Structure: _Z3 Q,y Qt,,c .37�'
Proposed Wastewater System Type:
Projected Daily Flow: i3 J6 GPD v k &.-
Number of bedrooms: Number of Occupants: E) e'y Ly max
Basement ❑Yes� 6o
Pump Required: glen ❑ No ❑be required based on final location and elevations of facilities
Type of Water Supply: 11 Community
Community Public ❑ Well Distance from well feet Permit valid for: ET --Five years
Permit conditions: ❑ No expiration
Authorized State Agent:: Date: �,/t" /2 it/1— SEE ATTACHED SITE SKETCH
The issuance of this permit by the Health Department in no way guarantees the issuance of other permits. The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This
site is subject to revocation if the site plan, plat, or the intended use changes. The Improvement Permit shall not be affected by a change in ownership of the site. This permit is subject to compliance with the provisions of
the Laws and Rules for Sewage Treatment and Disposal and to conditions of this permit..
Construction Authorization
(Required for Building Permit)
The construction and installation requirements of Rules .1950, .1952, .1954, .1955, .1956, .1951, .1958. and .1959 are incorporated by references into
this permit and shall be met. Systems shall be installed in accordance
with the attached system layout.
ISSUED TO: �)(Z ( J c c it PROPERTY LOCATION: �e
Jc�nstlo�,ed
�,1 SUBDIVISION
LOT #
Facility Type: E New ❑ Expansion ❑ Repair
Basement? ❑ Yes b No Basement Fixtures? ❑ Yes ❑ No
Type of Wastewater System** &OAP}_% C"ye ' '.cam' X
(Initial) Wastewater Flow: 8 76 GPD
(See nate below, if applicable ❑) pp
7vn* tr ARepair)
Installation Requirements/Conditions Number of trenches
Septic Tank Size '�O00 gallons Exact length of each trench `70 feet
Trench Spacing: Feet on Center
Pump Tank Size d,00 0 gallons Trenches shall be installed on contour at a
Soil Cover: to inches
Gam° -QCT ° /C7U0 �.tivw Maximum Trench Depth of. /8-30 inches
(Maximum soil cover shall not exceed
(Trench bottoms shall be level to +/-1/4"
36" above the trench bottom)
in all directions)
Pump Requirements: ft. TDH vs. GPM
'p inches below pipe
r
Conditions: Fe a c Cc,� t/,, Jc,,— M `e� oK I: ile, r , 7 v d �'��o
Aggregate Depth: a2 inches above pipe
s,— inches total
.AL
WATER LINES (INCLUDING IRRIGATION) MUST BE ]OFT. FROM ANY PART OF SEPTIC SYSTEM OR REPAIR AREA.
NO UTILITIES ALLOWED IN INITIAL OR REPAIR DRAIN FIELD AREA.
**If applicable: /understand the system type specified is different from the type specified on the application. / accept the specifications of this permit.
Owner/Legal Representative Signature: Date:
Ims Lonstruetlbn Authorization is subject to revocation it the site plan, plat, or the intended use changes. the Construction Authorization shall not be transferred when there is a change in ownership of the site. This
Construction Authorization is subject to compligA with the provisions of the Laws and Rules for Sewage Treatment and Disposal and to the conditions of this permit. SEE ATTACHED SITE SKETCH
Authorized State AgentXC Y_Z Date: _Z_12 r" -
Construction Authorization Expiration Date: f 04C
HTE# /'%=.7Y -76G 11L 4 Permit # -2 e) -z b 7
Harnett County Department of iblic Health
Site Sketch
PROPERTY LOCATON:_
ISSUED TO: G C c SUBDIVISION LOT #
Authorized State Agent: Date: 7" It-r—
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